Something dramatic and new has been happening over the last decade: IVF centers in the U.S. have progressively given up on maintaining their own egg donor pools. In the initial stages of this development, the reasons were mostly financial: it is expensive and very time-consuming to screen large numbers of candidates to select only a few, among which, again only very few, will be selected by patients as their egg donors and will go through IVF cycles. In other words, maintaining egg donor pools is usually a money losing proposition for IVF center.
This was recognized not only by IVF centers but also by entrepreneurs, who quickly realized that serving a number of IVF centers and the public, all at the same time, can make the donor selection process a profitable business model. IVF centers, therefore, started closing down their own donor programs or converting them into independent agencies that served multiple IVF centers at once and also offered the public access to their egg donor pools. These developments alone dramatically reduced the number of IVF center-based egg donor pools.
The numbers, however, very quickly fell further with the establishment of frozen donor egg banks. Such banks have opened up all over the U.S. and are gaining quickly in popularity. There are good reasons for their popularity because in many ways egg banks simplify the egg donation process. That is especially true for IVF centers, which now no longer carry the burdens of screening and selecting their own egg donors. They now also can choose the timing of donor egg recipient cycles at their convenience instead of being dependent on the donors’ time schedules and menstrual patterns. Once eggs are frozen, they, of course, can be thawed at any time, even on short notice.
A second advantage of donor egg banks is the expanded donor choice. Because of associated expenses, even large IVF centers usually maintained only small active donor pools. Frequently, that offered little choice to patients who really had to accept what was available when reaching the front of the waiting queue of recipients. With so many frozen egg banks now offering eggs, patients, of course, have considerable choice.
Among the most widely heard arguments in favor of donor egg banks is lower cycle costs. Yet, we are unaware of studies that actually confirm this fact. Indeed, considering the high fees donor egg banks charge for each egg, the cost-effectiveness issue really should be thoroughly investigated before conclusions are reached. Because such an investigation may offer surprising results, industry is, of course, not very interested in pursuing such studies, and CHR, for the time being, remains skeptical about the industry stance that use of frozen donor eggs lowers cycle costs. The process, however, clearly financially benefits IVF centers.
Donor egg banks also offer considerable downsides, and those are the principal reasons why CHR has not joined the rush toward utilization of frozen eggs and still continues to maintain its own egg donor pool. Some of CHR’s concerns are data drive, while others are only intuitive though potentially no less important:
This is a part of October 2018 CHR VOICE.
Norbert Gleicher, MD, leads CHR’s clinical and research efforts as Medical Director and Chief Scientist. A world-renowned specialist in reproductive endocrinology, Dr. Gleicher has published hundreds of peer-reviewed papers and lectured globally while keeping an active clinical career focused on ovarian aging, immunological issues and other difficult cases of infertility.
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